On wounds of the heart / by James F. West.

  • West, James F., 1833-1883
Date:
[1870]
Catalogue details

Licence: Public Domain Mark

Credit: On wounds of the heart / by James F. West. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    more apparent. Skin hot. Tongue dry, but no thirst. Bowels moderately opened. 15th.—Very feverish. Flushed cheeks, and a dry and white tongue. Skiu hot and dry. Respiration about the same, but accompanied with more riles. Cough much worse, and of a dry hacking nature; sleep much disturbed by it. Moaned a great deal during sleep. Feet quite warm. 16th.—Seems much better. Cough not so troublesome. Did not pass so rest- less a night. Fever much abated. Tongue more healthy. Extremities warm. Wound still extending its edges; is now about the size of a half-crown piece, with a great deal of sero-purulent discharge. Upon pressing in the intercostal spaces a very curious sound was heard, perhaps the term frottemeut will best convey the idea. Respiration and pulse about the same. 17th.—Was found sleeping, and respiration was observed much easier. Pulse about 156, and full. He says his “ chest gives him a violent pain when he draws in his breath.” Wound remains the same, both in appearance and as to quantity of discharge. Appetite improved. Bowels moderately opened. Tongue almost natural. 20tli.—This morning seems much worse, and, indeed, says “ that he feels very ill.” Pulse quick and rather full. Respiration not more than 40. Cough the same, worse at night. Tongue moist, and of a brick-red colour. Breath very offensive. Bowels moderately opened. Skin cold, and no thirst. The wound still discharges freely, but the discharge is of a more serous nature. Opening in the chest larger, allowing of a very free admission of air, which is forced out at each expiration. The before-mentioned sound (frottement) may be heard over the whole chest. Not so much rale when he breathes. 24th.—Since the last report he has continued about the same, none of the symptoms alleviated and none sensibly worse, but during the preceding night he has had two rigors, the first of which lasted about a quarter of an hour. Pulse quick and small. Tongue moist and bowels regularly opened. Lassitude has increased; the least exertion is wearisome to him. Nurse thinks his appetite a little im- proved. Cough still troublesome. From the 25th to the 29th no fresh symptom. 30th.—Lassitude evidently increased. Countenance more cadaverous. Bowels have continued open, sometimes being mueh relaxed. His tongue presents red edges, coated with a white fur in the middle. Pulse small and quick, accompa- nied by an undulating motion. Respiration 40. About 8 o’clock he had a rigor, which lasted for about twenty minutes, and he has been restless ever since. The wound in the pericardium seems to be growing over, so that much of the opening into the chest cannot be seen without looking from below upwards. On looking at the heart it appears to present an ulcerated surface, but this is perhaps only lymph deposited on its surface. The wound still discharges a great deal of sero-purulent fluid, rather offensive. The skin round it presents an appearance of granulation. Sore throat is complained of. December 1st.—This morning he appears rapidly sinking. Face pale and cadaverous. Talks incoherently. No report could be obtained from him, but the nurse said he passed a very bad night, getting out of bed two or three times, and
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